Help appreciated asap from a lay person with a neuroscience/pharmacology question pls

[3dmusic]

I hear that pregabalin potentiates opiates, but does it actually increase the time opiates are in your system?
Is there a scientific, or 'receptor' reason why pregabalin potentiates opiates.
I am asking, because I take opiates for two or three days at a time, then I have a day off, so, like 48hrs in between doses.

Before I took pregabalin, I used to take opiates about 5-6 times a week, some days dosing twice, and I never formed a physical dependency, even though i did it for five years, this is not boasting machismo, just the way my body works.

Since taking lyrica, I did not take more opiates, except for a short time over christmas when my usease spiked due to personal problems.

I then got myself addicted to pregabalin and have tapered from 600mg to 200mg since Christmas.
I am wondering if the pregabalin could be somehow 'increasing the availability of opiates in my system' and making me more at risk of addiction to opiates by taking pregabalin.
I dont have a science or medical background, I just thought this was the best place to ask this question.
Many thanks

 

[Nagelfar]

I did not take more opiates, except for a short time over christmas when my usease spiked due to personal problems.

I notice hangers-on to the forum often come through and have a bad habit of self-diagnosis, and much of the time it is my personal belief that they miss the mark. For instance, I think the above consideration (aforementioned "personal problems", not the stint of out-of-regimen usage) may in-fact be your culprit here. Many studies have shown that addiction can be triggered by stressors in otherwise exposed "occasional users" or medicinally indicated use of specific drug, can under-go a personal circumstance of even mild 'trauma' (for lack of a better word that comes to mind: anything from career failure, relationship issues, it only matters the priorities of the individual in question and how heavily it weighs / relatively insurmountable it feels for remedying the problem, for peace of mind / possible resolution, in that sphere of their life to them), and this actually wires your neurochemistry in a real way to render vulnerable your disposition to that previously well handled / under control use of a substance, into an addiction of that substance. Habituation going from a thing at hand, to the habituation of overweening impulse taking precedent beyond a healthy scope or measure.

 

[3dmusic]

Thanks, but my question remains unanswered, i know you helped but I still need to kno

I notice hangers-on to the forum often come through and have a bad habit of self-diagnosis, and much of the time it is my personal belief that they miss the mark. For instance, I think the above consideration (aforementioned "personal problems", not the stint of out-of-regimen usage) may in-fact be your culprit here. Many studies have shown that addiction can be triggered by stressors in otherwise exposed "occasional users" or medicinally indicated use of specific drug, can under-go a personal circumstance of even mild 'trauma' (for lack of a better word that comes to mind: anything from career failure, relationship issues, it only matters the priorities of the individual in question and how heavily it weighs / relatively insurmountable it feels for remedying the problem, for peace of mind / possible resolution, in that sphere of their life to them), and this actually wires your neurochemistry in a real way to render vulnerable your disposition to that previously well handled / under control use of a substance, into an addiction of that substance. Habituation going from a thing at hand, to the habituation of overweening impulse taking precedent beyond a healthy scope or measure.

hi @Nagelfar

Thanks for your reply, but I still have questions I would like answering, i bolded it, the main one.

I'm officially newly diagnosed Borderline Personality and C-PTSD from a psychiatrist I saw in early June.

I just want to know, does pregabalin increase the amount of opiates in the body or, does it just have a merely synergestic effect.

I'm engaging with drug agencies and my psychiatrist to get off drugs. I Tapered from pregabalin 600mg to 198mg, as I started getting withdrawals on the days, at Xmas wheh I wasnt taking pregab, few days off.
once I started tapering, 5 doses daily, split daily cut into five, my wd sx went away, but the diarrhoea has come back.
I went 72 hours without opiates, got no wd sx, but wondering if the 198mg of pregab I am currently on are covering up opiate withdrawals.
I normally take oipates 3-4 times a week.
Unfortuantately I still have unsnswered questions, but thanks for your help.

 

[palmanita]

No, pregabalin doesn't increase the amount of opiates (e.g. by inhibiting their metabolism) and it isn't a direct opioid receptor agonist either. But it has some synergetic / potentiating effects through its a2d calcium channel blocking property and probably increases GABA synthesis by inducing some enzyme.

Many report that pregabalin is of great help when ceasing opioid use. Probably it's not the best to go off both of them at the same time (seizure risk too). I can't say whether being on pregabalin for a long time still facilitates opioid down-titration, does nothing or even might begin to impede it though. When the calcium blocking effect remains as it should for an anti-epileptic then this might reduce the intensity of excitatory rebound from opioid reduction. If you're down at 200mg's now, I'd just keep it that way, use opioids as less as possible and as much as needed, and you'll have the option to go up with the pregabalin if you should want to cease opioids or take a break off their use.

I don't get physical addiction quickly either but it's a nasty thing. Regarding pregabalin I think one shouldn't over-rate the cases of withdrawal syndrome as many if not most of them experiencing it have went down quickly or abrupt. With slow reduction of the dose with time it's (for me) not hard to get off.

(Disclaimer: I'm a layman too.)

 

[3dmusic]

Thank you so much

No, pregabalin doesn't increase the amount of opiates (e.g. by inhibiting their metabolism) and it isn't a direct opioid receptor agonist either. But it has some synergetic / potentiating effects through its a2d calcium channel blocking property and probably increases GABA synthesis by inducing some enzyme.

Many report that pregabalin is of great help when ceasing opioid use. Probably it's not the best to go off both of them at the same time (seizure risk too). I can't say whether being on pregabalin for a long time still facilitates opioid down-titration, does nothing or even might begin to impede it though. When the calcium blocking effect remains as it should for an anti-epileptic then this might reduce the intensity of excitatory rebound from opioid reduction. If you're down at 200mg's now, I'd just keep it that way, use opioids as less as possible and as much as needed, and you'll have the option to go up with the pregabalin if you should want to cease opioids or take a break off their use.

I don't get physical addiction quickly either but it's a nasty thing. Regarding pregabalin I think one shouldn't over-rate the cases of withdrawal syndrome as many if not most of them experiencing it have went down quickly or abrupt. With slow reduction of the dose with time it's (for me) not hard to get off.

(Disclaimer: I'm a layman too.)

hi @palmanita, hope you enjoy reading this, I taper a specific way, designed by me, well partly.
Hi and thanks for your action.
The way some people taper pregab, no wonder they get bad wd sx. They skip days, thinking it will lessen the pregab in the blood. I cut daily, more on that below.
Thank you so much for reassuring me that pregabalin does not increase the amount of opiates, and isn't a direct opoid receptor agonist either.
Thank you for pointing out that it is only synergy/potentiation effects through the calc blocking channel etc

I think I was worrying needlessley that day.
I am recovering from a bad crossover from zolpidem addiction to valium, crossed over in order to taper off, but was half-dosing what I needed for weeks, and I think I am just starting to recover now.
I'm tapering, but just nipping a wee bit of daily, and have been for a month, just easing myself into it, if its like the last taper it should go ok.
Pregab one going ok, on 194mgs now, least I've ever taken in a day, and things aren't so bad at all.
Of course, as I am withdrawing from drugs and suffering excess anxiety, i'm even questioning my improvement in symptoms being down to an erroneous double dose of valium etc, when I count my dose carefully.

Money is what is making me taper both together. I cannot afford to supply myself with one drug, whilst I taper off another.
i feel forced to do the simultaneous tapers, but I'm doing them in the best way possible. With benzos, I've witnessed lots of people heal from bad tapers and taper down to 0mg with no symptoms, using the daily taper.
With pregab, its kind of an experiment. I'm doing the daily taper thing, but as duration of action is so short, I'm dosing 5 times a day, and cutting 0.4mg off each dose, 2mg total cut a day, 97 days to go, if I can stay on this cut, seems to be working fine at the moment.

I did an experiment. I went 72 hours without any opiates. I had no runny nose, vomitting, achy limbs. I had the anxiety and excess gut motility, that I'd had since crossing from zopiclone to valium and underdosing for so long, but even that seems to be getting better now.
Now it's the turn of the tearfulness to dissappear. Then the anxiety and negativity.
I need more faith in life, things do wotk out right.
Hope you enjoyed reading this
what do you think?